even more older people have to take care of themselves

• Foot lying on the ground

  news editor

The list of elderly and sick people waiting for a place in a nursing home is growing: more than 21,000 people in the Netherlands are now waiting for 24-hour care, according to data from ActiZ, the trade association of nursing homes.

Due to staffing problems, not all places in care homes can already be filled by residents. The problem is becoming more pressing with a rapidly aging population. Healthcare workers will also retire in the next few years. “With 30% fewer staff, we will have to provide intensive care to the same group and even more elderly people in the future,” says Mireille de Wee, director of ActiZ.

The massive construction of care homes due to the ‘grey wave’, however, is not seen by Aged Care Minister Conny Helder as the solution. “Maybe we can still build the nursing homes, but we don’t have the staff to provide them,” he said in a parliamentary debate last month.

It’s not canceling construction plans at a very late stage, but ultimately Helder wants to structurally keep the number of nursing home places at 130,000, the same as it is now. She prefers to use the remaining caregivers who are still there at home.

In the Minister’s opinion, the elderly themselves will be called upon much more than at present to keep themselves as healthy and independent as possible. This must include the use of technology. Family members and acquaintances will also need to help more often. Furthermore, the elderly will have to move in time to a suitable home, without thresholds and stairs.

Together with Minister Hugo de Jonge (Housing), Helder presented his plans yesterday to build more homes for the elderly. These are houses without stairs (170,000), cluster houses (80,000), where the elderly live together in a condominium and help each other so as not to waste away, and shared living spaces for people with dementia, for example, who receive assistance nursing at home (40,000).

The opposition in the House is extremely critical. They fear that if there aren’t enough places in nursing homes, elderly people in great need will languish at home. GroenLinks and PvdA are calling on the minister to build 25,000 more places in nursing homes. This will be voted on in December.

The question is whether the houses, as envisaged by Minister Helder, will be ready in time for the growing group of elderly people. That’s also a concern of his own, he admitted earlier in the House of Representatives.

Another crucial question: is it possible to manage personnel in those forms of housing with less care? Not if you only bring together people with severe dementia, admits ActiZ’s Mireille de Wee. “Then you need the same number of health workers. But it may be possible with a mix of viable and less viable older adults.”

The Habion senior housing cooperative already builds affordable cluster houses. They have fourteen such complexes across the country, including “Liv inn” in Hilversum. The apartments are built in such a way that the elderly can continue to live here if they need care. Until their death.

The doors are wide enough to fit into a dumbwaiter or high-low bed, there are no thresholds, and the apartments are already equipped with aids such as a folding chair in the shower. There is always one health worker present in the complex, part of the day there are two. But there are more than 170 residents, 145 of whom are over 65 years old.

The organization aims for an ideal mix of residents, where a relatively small number of older adults are in need of care, but a larger proportion of residents are vital. The latter group can therefore help. Not with medical care, but with groceries, cooking, offering companionship, or taking a walk with a restless, demented neighbor. This should relieve professional care.

Resident Gerard Scheper is thrilled. He is still relatively young at 67 years old. Today he visits his octogenarian neighbor who is dying. The neighbor would rather die in hospice, but he’s on a waiting list. Scheper keeps him company. He himself has experienced how pleasant looking after neighbors can be.

For people to help each other is “a great concept,” agrees Angelique Pompaltena, a nurse at the Liv inn. “You can really see that people are available and that relieves me as a carer. If someone falls out of bed at night and I’m alone, there’s always someone who wants to help. This saves the caregiver,” she says.

But, Pompaltena adds, the care team can’t handle it if too many people become employees here. “Or you have to employ more health personnel. But there is also a shortage of district nurses.”

A resident of the inn Liv with dementia often wanders and hardly speaks anymore. She’s gotten a lot worse, reports his son. So bad that she is now on a waiting list for a nursing home. Because certainly not everything is possible in a cluster housing form.